Housestaff Spotlight: Winter 2018

Edward Briercheck, MD PGY 3 Resident

Specialty

Global Health and Hem/Onc

Pathway

Global Health

Professional Interests

My career focus is on the intersection of global health equity and cancer care. Cancer encompasses a broad range of diseases that can be relatively mild to rapidly fatal. What we know now is that most cancer deaths are occurring in low- and middle-income countries. Tragically many of these deaths could be prevented (example cervical cancer) or successfully treated (example lymphoma) if patients had access to an equipped healthcare system. Our current generation of cancer innovation has the opportunity to not only cross the frontiers of discovery but the barriers of borders and inequality.

Current Projects

My clinical experience in low-resource cancer care began as a student at the INCAN cancer hospital in Guatemala City, Guatemala. One of the barriers to care in Guatemala and other low-resource settings is obtaining a proper diagnosis. This is limited by cost and an adequate number of highly trained pathologists. Along with my former attending at INCAN Dr. Fabiola Gamboa-Valvert and my current research mentor Dr. David Weinstock at the Dana-Farber Cancer Institute (as well as the laboratory of Dr. Yaso Natakunam at Stanford) we developed a research project that aims to solve this problem through an inexpensive and simple gene based diagnostic tool for lymphoma. This would drastically cut the cost to patients and provide a higher level of precision in their diagnosis. The current immunohistochemistry based diagnostic tests for lymphoma cost patients $450 or around 11% of the median income in Guatemala. We believe that we could produce a more accurate test based upon gene expression for $10. Further, with enough resources we could easily scale such a system to other regions and cancer types.

Locally, at BMC we have an awesome opportunity to see patients from all over the world, so my interests in “Global Oncology” presents itself frequently on the wards. Greater than 1/3 of our patients in hem/onc clinic have no or limited English proficiency. This can make communication around sensitive topics like end of life care, and very practical issues like diarrhea associated with chemotherapy difficult to discuss. The organization Global Oncology along with the local design firm The MEME created some fantastic education tools to assist at their international cancer sites. These are currently available in Spanish, Haitian-Creole, Kinyarwanda, Setswana and English. Led by Constance Fontanet a BU public health student and Dr. Naomi Ko we’re working on adapting these materials to assist our diverse patient population.

Favorite experience, case, or project

The opportunity to have such an immersive and focused global health education experience in India as part of the Global Health pathway was an irreplaceable and unique part of my training. As I cycle through my collection of interesting cases and formative experiences it is hard to say one is a favorite. The theme that does recur is how incredible my peers have been through the process. Their impressive knowledge pushed me to be a better resident. Their humor and kindness made me a better human.

One goal you hope to accomplish in the future

A lot of people die for dumb reasons like money and location. I’d like to stop some of that from happening.

One thing you are going to miss from residency

The friendships and camaraderie of my peers…and in a few months the chance to call the attending.

You can learn more about Ed’s global health adventures by following him on Twitter @eddiebriercheck